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Should I listen to my Doc?

L

loudsally

Member
Messages
10
Location
Side, Antalya, Turkey
Hi everybody,
i'm six weeks pregnant and have just been to see a diabetic specialist regarding the condition and treatment during pregnancy.
I was on Lantus and Novo-rapid, everything has been honky dory for years, I have good control and am well adjusted with my diet and lifestyle. WAS well adjusted i should say!
This Doc has told to me stop taking the Lantus, not ween off it, just to stop. Apparently this is because the effects during pregnancy have not been studied yet! I posted on another thread about this last week and a few diabetic mothers said they took Lantus all through their pregnancies and had no ill effects. He also told me to up my Novo doses far more than I would have thought necessary which is a concern because I have heard how dangerous hypo's can be during pregnancy and I have always judged how much Novo to take according to what i'm eating because I cant exist on the same food every **** day! I dont understand the logic behind takng the same amount of insulin with a light breakfast as I would take with a three course dinner!!!
I'm just thinking that it may be more harmful to just stop taking Lantus so suddenly but until I do it I dont know what the result will be. I'm wondering if I should ignore the Doc and keep lowering my dose over the next week or so to stop gradually. To be honest I would feel happier to just carry on with what my body is accustomed to but of course I would never want to endanger my unborn child and I just feel so torn :roll:
Any advice gratefully accepted x
 
I'm not in your situation, but it is your body and your baby, so I would say research everything and go with your instinct. If necessary see another doctor.
You could ask about Levemir for your basal.
Have you seen the diabetes specialist midwife yet? she/he might help
 
Erm...I wish it was that straight forward.
I live in Turkey and unfortunately we dont have diabetic midwives here...in fact we dont have midwives, we have a gynaecologist and thats it. There aren't really diabetic specialists either for type 1 because type 2 is so common here that you very rarely see an insulin dependant diabetic.
Diabetes is known as sugar sickness here and when you tell someone, even doctors, you have it their first question is always "So whats your bg". When i tell them my numbers (which are quite normal) the instant reaction is "Well then, you dont have sugar sickness!"
It's incredibly difficult to get people to understand that my bg is only normal because i take insulin and i'm not sure that this doctor understands my concerns about stopping the Lantus because my readings are good.
He apparently is the only diabetic doctor (hahaha) in the area but I'm just not sure i trust him.
I have problems trusting doctors generally after being mis-diagnosed in the first place and having a really terrible doctor when i first started on insulin who told me that I must NEVER eat ANY fruit again...EVER! Maybe the problem is that i'm just too self-reliant :wink:
To be honest the medical system here is absolutely fantastic and bang up to date but the attitude towards diabetes is just very old fashioned.
 
Sorry there isn't an easy answer Sally, but here is a famous doctor in California, called Lois Jovanovic. It would be worth contacting her and asking some general questions. She specialises in pregnancy in diabetes. She probably wouldn't answer anything that intruded on another doctor's case, but she might tell you if stopping Lantus in pregnancy is a usual thing to do. You can google her name and make a contact through the clinic she runs.
In any case look on Amazon for her books. Your questions might well be dealth with there. She's the grandchild of Dr. Banting's first patient
Best wishes
Hana
 
You're type 1 and he's telling you to stop taking your basal insulin? Is he a real Doctor? :o

Look, I'm not even going to pretend to understand the finer points of midwifery or gynaecology but diabetes I do know. How did he suggest you compensate for the lack of background insulin after stopping Lantus?

If he doesn't want you on Lantus, get him to put you on something like Levemir. You need a replacement agent or you'll go completely out of control. :|

Also, this: http://www.reuters.com/article/healthNe ... 7720070421
 
First of all; congratulations on your pregnancy - my wife and I have just had our first child and it's been such a wonderful thing :D

Secondly, I have no specific information on Lantus and pregnancy and/or treatment of pregnant mothers but what is being suggested sounds like he's saying stop the basal and up the bolus insulin. That is crazy. If this worry is Lantus specific switch to Levemir, or start a mixed insulin regime, but don't throw away half of your insulin regime... :!: Otherwise you will inevitably be chasing highs and lows which cannot be a good thing.

Why not phone up NHS Direct in the UK and ask their advice; are you a UK citizen? If so it shouldn't be a problem?

That advice sounds really worrying to me though - I hope you get some specific answers from a doctor who knows what they are talking about.

All the best

Dillinger

Edit - here is a post from another forum that directly addresses this :

http://www.diabetesforums.com/forum/dia ... nancy.html

I would say; don't stop your Lantus; ignore your doctor.

All the best

Dillinger
 
Ignore your doctor.

A Novorapid only regime will give you a huge rollercoaster of blood sugars.
It's going to go sky high when you don't eat, and bottom out when you do.
Switching from Lantus is one thing, but completely cutting out long term is absolutely, stupidly dangerous.
There have been studies on the safety of Lantus during pregnancy, and it doesn't increase the risk of anything.

http://www.reuters.com/article/healthNe ... 7720070421

My daughter was born at 38 weeks, 6lb8. 16 m/o now and a terror lol. I was on Lantus all the way through, and no problems, apart from nausea :S
I think if you are doing fine on Lantus now, there's no need to throw another complication in when there is no cause.
We know that bad sugar, especially during the first three months, can be very detrimental.
Lantus hasn't had a huge scale trial to prove it's safe, but there is no reason to suspect it's not.

So i'd stick with the Lantus. But honestly, your doctor has absolutely no idea what he's on about.
You CANNOT sustain a steady glucose with just novorapid at meal times.

That will be dangerous.
 
I thinnk, if it were me from anecdotal info on forums and the small amount of positve research evidence that I'd continue with lantus.
It does seem that the intermediate insulin insulatard does not pass the placenta so is a possible alternative
http://emc.medicines.org.uk/medicine/3512
 
As Novorapid is a fast acting insulin that tails off after 4-6 hrs (max I think), surely stopping yr Lantus would mean you would be risking DKA, esp overnight?
Yr Dr's advice sounds very dangerous to me, for both you and your baby.
Best wishes
Sue
 
Before you make any rash decisions. Book an appointment with him and ask him why you should stop your medication. There might be a perfectly good reason why.

If it's only because the effects haven't been studied then ask him what the effects of coming off it might be.

Don't just ignore his advice (after all he still had to go to medical school... Unless it's true that you can buy degrees in some places...).

Anyway, just question him relentlessly. And then explain that you don't want to do anything that could harm your baby and poor blood sugar control might do that... In fact it probably would.
 
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